Experienced Cerebral Palsy Injury Attorneys in Grand Rapids, Michigan

Having a doctor diagnose your baby or child with cerebral palsy can be scary and devastating. At its simplest definition, cerebral palsy is a brain injury that affects movement. “Cerebral” means relating to the cerebrum or brain, and “palsy” means weakness or problems in using muscles.

Cerebral palsy varies significantly in severity. Some children with CP go on to live normal, independent lives. Others are completely dependent upon others in their activities of daily living. There are several classification systems that categorize CP based on its symptoms and severity.

One method is to classify based on severity level:

• Mild: The child can move without assistance and his or her daily activities are not limited.
• Moderate: The child needs leg braces, medications, and adaptive technology to complete activities of daily living.
• Severe: The child will require a wheelchair and will have significant challenges completing activities of daily living.
• No CP: The child has signs of cerebral palsy, but the disorder was acquired after the completion of brain development. It is classified under the incident that caused the CP symptoms, such as traumatic brain injury or hypoxic ischemic encephalopathy.

Cerebral palsy can also be classified based on the parts of the body affected:

• Monoplegia / monoparesis: Only one limb is affected. (“Plegia” means inability to move. “Paresis” means weakness or limited range of motion.)
• Diplegia / diparesis: The legs are affected more than the arms.
• Hemiplegia / hemiparesis: The arm and leg on one side of the body are affected.
• Paraplegia / paraparesis: The lower half of the body, including both legs, are affected.
• Triplegia / triparesis: Three limbs are affected.
• Double hemiplegia / double hemiparesis: All for limbs are involved, but one side of the body is more affected than the other.
• Tetraplegia / tetraparesis: All four limbs are affected, with three limbs being affected more than the fourth.
• Quadriplegia / quadriparesis: All four limbs are involved.
• Pentaplegia / pentaparesis: All four limbs, the head and the neck are involved. The child may experience eating and breathing complications.

Cerebral palsy can be classified according to the type of movement function difficulty.

• Spastic: The child has increased muscle tone. The muscles may continually contract. Limbs are stiff and rigid. It is difficult to relax muscles. Movements are jerky. The tongue, mouth, and pharynx can be affected, making it impossible or difficult to talk, eat, swallow, or breath. About 70 – 80% of CP cases are spastic.
• Non-spastic: The child has decreased or fluctuating muscle tone. Non-spastic CP is further divided into "ataxic” and “dyskinetic.”
  • Ataxic cerebral palsy affects coordination, balance, and posture. Walking gait is abnormal. Eye control can be difficult and cause depth perception problems. Fine motor skills and hand-eye coordination is problematic. However, there are no involuntary movements.
  • Dyskinetic cerebral palsy means the child has difficulty controlling muscle movement and is marked by involuntary movement. Dyskinetic cerebral palsy is often broken down further based on the types and patterns of involuntary movements.

The Gross Motor Function Classification System (GMFCS) classifies CP by the extent of the impairment, similar to the severity levels, but more specific.

• GMFCS Level I: The child can walk without limitations.
• GMFCS Level II: The child can walk, but with limitations. He or she may not be able to walk long distances, or may have trouble balancing. The child cannot run or jump as well as a child at Level I.
• GMFCS Level III: The child needs adaptive equipment to assist with walking. A walker can be used in the home, but a wheelchair is likely needed outdoors and in the community, such as at school. The child can sign with limited support and has some independence in transitioning from sitting to standing.
• GMFCS Level IV: The child is able to move with the use of powered mobility assistance. They usually need support to sit. Self-mobility is limited.
• GMFCS Level V: The child has severe head and trunk control limitations. Extensive assistance is required. There is generally no self-mobility.

The various cerebral palsy classification systems can be overwhelming for parents. There is lack of agreement with various classifications and categories. And many children have features of multiple types of CP (which creates another category: “mixed CP”). When you choose Hoffer & Sheremet to represent your child, we understand that your priority is taking care of your child and learning everything you can about this new world you have been thrown into. We focus on your child's case so you can focus on your child.

Sources include:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5406689/

https://www.nichd.nih.gov/health/topics/cerebral-palsy/conditioninfo

https://www.nichd.nih.gov/health/topics/cerebral-palsy/conditioninfo/types

Early diagnosis and treatment can improve long-term outlook. If the birth is traumatic or your baby's physician has reason to suspect that your child may have cerebral palsy, there will be testing performed by specialists such as pediatric neurologist, pediatric physical medicine and rehabilitation and child development specialist. There will also be brain scans to see if there are any identifiable abnormalities in your child’s brain.

Early diagnosis and intervention for children with cerebral palsy is recommended; a "wait and see" approach in diagnosing CP can restrict the child’s motor and cognitive gains and even worsen parental mental health. For children younger than 5 months old, the detection of abnormal motor function plus an abnormal MRI (showing damage to the motor areas of the brain), accurately predicts cerebral palsy more than 95% of the time. For children over five months of age, a score lower than 73 on neurological clinical examination, with an abnormal brain MRI (showing damage to the motor areas of the brain) accurately predicts cerebral palsy 90% of the time.

Sometimes, the symptoms of CP are not apparent in babies, especially when CP is mild. Diagnosis usually occurs by about 18 months of age, but it could be later.

The law allows us to wait to see how the baby's injuries develop. When brain damage or other injury occurs at birth, a case can be filed any time before the child's 10th birthday. In cases of mild CP, it is important not to settle the case until we have a good idea of the extent of the child's injuries and limitations. Otherwise, the settlement amount could be too low.

Because we specialize in birth injuries and representing injured babies and children, we know when it's the right time to file and settle your child's case.

Sources include: https://www.aacpdm.org/publications/care-pathways/early-detection-of-cerebral-palsy

Cerebral palsy can be the result of either abnormal brain development or injury to the baby's brain during labor and delivery, such as hypoxic ischemic encephalopathy.  In the latter situation, the brain damage could be the result of medical malpractice if there was prolonged labor, shoulder dystocia, infection, cord compression or other birth trauma that resulted in decreased or lack of oxygen to the brain.

If the labor and delivery was mismanaged by the doctor, mid-wife, or other healthcare providers, and your baby as cerebral palsy as a result, you may be able to sue the healthcare providers for causing cerebral palsy.

Unfortunately, there is no cure for cerebral palsy. A child cannot "out grow" cerebral palsy. However, there are treatments, aids, and modifications that can help alleviate symptoms and make the child more comfortable.

When we are planning your birth injury lawsuit settlement or how much to ask the jury to award, we take into account all of the treatments, aids, and modifications that can make your child as comfortable as possible under the circumstances. We use reputable life care planners that map out what your child will need throughout their life.

Treating cerebral palsy is specific to the needs of the individual. The initial brain damage cannot be reversed, but aggressive therapies can help the young brain to compensate and improve functioning.

Ideally, a treatment team will develop a holistic plan that may include:

• Physical therapy: This therapy focuses on improving movement, muscle strength, and balance.
• Occupational therapy: This therapy helps the child to learn to complete activities of daily living.
• Recreational therapy: This therapy assists children with recreational activities such as art and sports.
• Speech and language therapy: You may be surprised to learn that speech therapists help with more than speaking. Speech therapists can help with swallowing and alternative means of communication.
• Orthotic devices: These medical devices include braces, splints, walkers, wheelchairs, and scooters.
• Assistive technology: Devices such as computer-based communication devices or velcro shoes can help make it easier for a child to live with CP.
• Medication: Medications may be prescribed to help relax the muscles and reduce involuntary movements.
• Surgery: For very severe CP, surgery may be done on the nerves or muscles.

Sources include:

https://www.nichd.nih.gov/health/topics/cerebral-palsy/conditioninfo/treatments

Cerebral palsy is one of several birth injuries that can entitle the victim to a legal claim for damages. Cerebral palsy occurs in about 1 to 4 out of every 1,000 live births, and sometimes this is due to medical malpractice. A cerebral palsy birth trauma lawsuit can be due to a number of potential malpractice issues including:

• Failing to perform a C-section
• Mistakes during a C-section
• Failure to monitor or respond to fetal distress
• Not treating jaundice
• Using excessive force with birth-assisting tools
• Improper usage of anesthesia
• Oxygen deprivation due to a slow delivery